Adequate Antenatal Care Visits are Associated with a reduction in the Odds of Low Birth Weight in Zambia: Evidence from the Zambia Demographic and Health Survey.

BackgroundLow birth weight (LBW) remains a major public health challenge in low and middle-income countries and is associated with increased risks of neonatal mortality, impaired growth, and adverse developmental outcomes. Antenatal care (ANC) provides essential interventions that support maternal health and fetal growth; however, many women do not achieve the recommended number of ANC visits. This study is therefore aimed at providing evidence of the protective effect of adequate ANC against LBW in the Zambian context. MethodsWe conducted a cross-sectional analysis of data from the 2001-2024 Zambia Demographic and Health Survey (ZDHS). The study included non-anemic women aged 15-49 years with a recent singleton live birth and available birth weight information. Low birth weight was defined as birth weight <2500 g. Antenatal care attendance was categorized as 0-3, 4-7, and [&ge;]8 visits. Choropleth maps and trendlines were used to show the spatial and temporal variation of LBW. Survey-weighted descriptive statistics, logistic regression models and predicted probability were used to estimate crude and adjusted associations between ANC visits and LBW while accounting for the complex survey design. All analysis were performed in STATA version 17. ResultsA total of 3644 non-anemic women with recent singleton live births were included in the analysis. The overall prevalence of LBW was 8.7%. The prevalence of LBW was higher among women who attended 0-3 ANC visits compared with those who attended 4-7 visits or [&ge;]8 visits. In adjusted analyses, attending 4-7 visits (AOR; 0.57; 95% CI: 0.42-0.78) and [&ge;]8 visits (AOR 0.51; 95% CI: 0.27-0.99) was associated with lower odds of LBW compared with 0-3 visits. The probability of LBW decreased with an increase in the numbers of ANC visits. ConclusionLow birth weight remains a significant public health concern in Zambia. Higher ANC attendance was associated with lower odds of LBW, supporting the importance of achieving adequate and sustained ANC during pregnancy. Strengthening strategies to promote early initiation and continuity of ANC, alongside addressing broader socioeconomic and nutritional determinants, may contribute to improved birth outcomes in Zambia.